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Exotics & Lab Animal Medicine > Common Reptile Diagnostics > Flashcards

Common Reptile Diagnostics Flashcards

1
Q

What would be the safe volume of blood to take from the following reptiles?

  • Nagini, 3 y/o FI, 60 g
  • Lizzie, 6 y/o FI, 2 kg
A

total safe amount is 1% of BW in grams

  • .01 x 60g = 0.6 mL
  • .01 x 200g = 20 mL
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2
Q

What are the preferred blood collection sites for chelonians, snakes, lizards, and crocodilians?

A

CHELONIANS - subcarapacial sinus, jugular, coccygeal, brachial plexus

SNAKES - cardiocentesis, palatine, ventral coccygeal

LIZARDS - ventral coccygeal, ventral abdominal, jugular

CROCODILIANS - post-occipital sinus, coccygeal;

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3
Q

What should be done once blood is successfully obtained from a reptile? What is the anticoagulant of choice?

A

blood smear

heparin

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4
Q

What 2 erythrocyte parameters are for reptile bloodwork?

A
  1. PCV - 20-45%, within (heparinized) microhematocrit tubes
  2. RBC - reptile automated cell counter, manual hemocytometer + staining/dilution
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5
Q

What are the main 2 options for staining/diluting RBCs for manual counting on a hemocytometer?

A
  1. Eopette/Leukopette (Phloxine B) - only stains granulocytes
  2. Natt-Herricks solution - can differentiate RBCs (small lymphocyte) and WBCs (thrombocyte)
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6
Q

Hemocytometer:

A
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7
Q

What is the normal morphology of reptile RBCs? How do immature ones compare to mature ones?

A

oval with an irregularly marginated nucleus

immature RBCs are smaller, rounder, and have basophilic stippling

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8
Q

What are 3 locations that new RBCs are produced in reptiles?

A
  1. BM
  2. extramedullary = liver, spleen
  3. mature circulating cells divide and form daughter cells (will have mitotic figures)
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9
Q

How can reticulocytes be observed on a blood smear? How much of the RBC should they take?

A

new methylene blue

2.5% or less

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10
Q

How are WBCs measured in reptiles?

A

different morphologies compared to mammals and cannot use an automated counter —> manual counts on blood smears stained with Romanowski or Wright-Giesma

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11
Q

RBCs and WBCs:

A
  • large arrowhead = lymphocyte
  • asterisk = thrombocyte
  • arrow = azurophil
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12
Q

What is the most common granulocyte in reptiles? What are the 2 major aspects of its morphology?

A

heterophil - analogous to neutrophils

  1. round, clear cytoplasm
  2. eosinophilic, elongated/spindle-shaped granules
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13
Q

What are 4 indications of toxic heterophils? What does this mean?

A
  1. basophilic cytoplasm
  2. abnormal granules
  3. vacuoles
  4. degranulation

a way to monitor chronic disease processes

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14
Q

What are the 2 major morphological aspects of eosinophils? What species lack them?

A
  1. similar in size and shape to heterophils with an eccentric nucleus
  2. spherical (red) granules —> “gumballs”
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15
Q

What WBC is seen in this blood smear?

A

green iguana eosinophil

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16
Q

What are the 2 major morphological aspects of basophils? What must they be differentiated from?

A
  1. smaller
  2. darkly basophilic granules obscure central, nonlobed nucleus

toxic heterophils

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17
Q

What are the 5 major morphological aspects of lymphocytes?

A
  1. lack granules
  2. high nucleus:cytoplasm ratio
  3. basophilic cytoplasm
  4. phagocytosed particles or RBCs can be seen in cytoplasm
  5. contour to surrounding cells
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18
Q

What do reactive lymphocytes indicate? What is their morphology like?

A

antigenic stimulation

  • basophilic cytoplasm
  • contain discrete punctate vacuoles
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19
Q

What is the morphology of monocytes like?

A

largest leukocyte with variably shaped contour and nucleus

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20
Q

What is a common variation of monocytes in reptiles? How do they compare in species?

A

azurophils

  • non-squamates = normal variation of monocytes containing azurophilic granules
  • snakes = distinct cell type that function similarly to neutrophils and contain fine granules and round nuclei
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21
Q

Label the cells seen in this blood smear.

A
  • arrow with long arrowhead = monocyte/azurophil
  • normal arrow = heterophil
  • large arrowhead = lymphocyte (low cytoplasm!)
  • skinny arrow with large arrowhead = eosinophil
  • asterisks = RBC
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22
Q

Label the cells seen in this blood smear from a snake.

A
  • large arrowhead = lymphocyte (low cytoplasm!)
  • asterisk = thrombocyte
  • normal arrow = azurophil (darker, large cytoplasm, small nucleus)
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23
Q

What are the 3 major morphologic aspects of thrombocytes?

A
  1. small, oval basophilic cells
  2. central basophilic nucleus
  3. pale-blue or colorless cytoplasm

(*)

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24
Q

Label the cells seen in this blood smear.

A
  • arrowhead = eosinophil
  • long arrow with large arrowhead = monocyte (large cell!)
  • 2 normal arrows = heterophils
  • asterisks = thrombocytes
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25
Q

What can indicate a left shift on blood smears? Infection?

A

presence of myelocytes and metamyelocytes in circulation

intracellular bacteria within WBCs

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26
Q

What are some factors that affect the normal reptile hemogram?

A
  • species
  • slide staining and evaluation technique
  • health status
  • nutritional status
  • age
  • reproductive status
  • stress level
  • gender
  • venipuncture site
  • season
  • hibernation status
  • captivity status
  • environmental factors
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27
Q

What is considered anemic in reptiles? What is indicative of regeneration? How does this compare to mammals/birds?

A

PCV < 15%

polychromasia

RBCs are much longer lived in reptiles (600-800 days), therefore response of regeneration is muted

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28
Q

What are some common causes of chronic anemia? Acute?

A

CHRONIC - infectious/infestations, improper husbandry and nutrition, toxicity, chronic organ failure, neoplasia

ACUTE - blood loss

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29
Q

What is a common cause of anemia in reptiles due to collection methods?

A

lymph contamination —> hemodilution

  • decreased PCV and increased lymphocytes with no evidence of regeneration
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30
Q

What is considered polycythemic in reptiles? What is the most common cause?

A

PCV > 40%

dehydration —> increased PCV and TP (common cause of kidney failure in chameleons)

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31
Q

What are 3 causes of inclusions seen in RBCs on blood smears?

A
  1. artifact from staining
  2. viral particles
  3. hemoparasites - Hepatozoon, Plasmodium (commonly subclinical)
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32
Q

Why is infection commonly challenging to diagnose in reptiles?

A

single leukogram is not indicative of chronic diseases commonly affecting reptiles

  • long term monitoring of blood work recommended
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33
Q

What is the prefered method of interpreting WBC in reptiles when diagnosing infections in reptiles?

A

follow the WBCs over time rather than a single point sample —> more important to interpret differential and leukocyte morphology

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34
Q

What are 4 common causes of leukocytosis?

A
  1. inflammation/immune response
  2. infection
  3. stress
  4. neoplastic leukemia - snakes, lizards
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35
Q

What are common causes of leukopenia in reptiles?

A
  • increased loss or destruction
  • decreased production
  • prolonged Fenbendazole use
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36
Q

What is the most common cause of abnormal biochemistry values in reptiles? What is used for these panels?

A

lymph contamination —> reduces all values, especially TP and K

use of panels/rotors specific for reptiles/avian species

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37
Q

What makes up the TP value? How is it interpreted?

A

albumin + globulins + fibrinogen fractions

compare ALB to GLOB

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38
Q

Where is albumin produced? What is its purpose?

A

liver

maintain oncotic pressure

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39
Q

What are common causes of increased and decreased albumin?

A

INCREASED - dehydration, reproductively acitve female (yolk formation!)

DECREASED - reduced intake of amino acids, reduced production due to liver disease, increased loss from GIT and kidneys (+ burns)

40
Q

What produces globulins? What offers the most detailed summary?

A

immune system

commonly calculated on normal panels, but gel electrophoresis differentiates albumin from alpha, beta, and gamma globulins

41
Q

What are the most common causes of increased and decreased globulins?

A

INCREASED - inflammation (gamma = chronic)

DECREASED - rare

42
Q

What are the 4 major liver parameters included in reptile biochemistry panels?

A
  1. ALT - liver, kidneys, other tissues
  2. ALKP - liver, kidneys, intestines, bone
  3. AST - fairly sensitive for liver disease + kidney, muscle
  4. bile acids - more reliable indicator of hepatic function
43
Q

What are some liver parameters not as commonly included in reptile panels?

A
  • GGT - little to no activity in most tissues
  • LDK - fairly nonspecific, liver, kidneys, other tissues
  • GDH - liver
  • biliverdin - product of RBC breakdown, lack biliverdin reductase = no bilirubin
44
Q

What is a more common renal parameter included in reptile panels? What is the more important reference for kidney disease?

A

uric acid —> produced by liver, carnivore > herbivore

Ca:P (2:1) - <1 = renal disease

45
Q

What are causes of increased and decreased uric acid in reptiles?

A

INCREASE - dehydration, acute renal failure, postprandial —> causes gout!

DECREASE - hepatic disease

46
Q

How do reptiles metabolize sodium? What are common causes of increases and decreases?

A

cation present in the extracellular fluid —> ingested in the diet and excreted by kidneys

  • INCREASE = increased intake, dehydration
  • DECREASE = renal disease, GI loss, seasonal
47
Q

How do reptiles metabolize potassium? What are common causes of increases and decreases?

A

cation present within cells —> ingested in the diet and excreted by kidneys

  • INCREASE = increased intake, renal disease, urinary obstruction, redistribution into ECF (acidosis)
  • DECREASE = reduced intake, increased GI or renal loss, redistribution into cells (redistribution syndrome)
48
Q

What makes up total calcium? What causes artifactual changes? What is it regulated by?

A

iCa + protein bound Ca + chelated Ca

  • sample analyzed
  • storage time
  • sample pH

PTH, calcitonin, calcitriol

49
Q

What are some causes of iCa increases and decreases?

A

INCREASE = excessive Ca or vit D3 supplementation, osteolytic bone disease, primary hyperparathyroidism, pseudohyperparathyroidism, reproductively active female (laying egg shell)

DECREASE = insufficient dietary Ca or vit D3, inadequate UVB light, excessive dietary P, renal disease, hypoparathyroidism

50
Q

What are phosphorus levels related to? What are some causes of increases and decreases?

A

Ca levels

  • INCREASE = renal disease, nutritional secondary hyperparathyroidism, normal in young animals
  • DECREASE = anorexia
51
Q

What do creatinine levels indicate? What are 2 causes of increases?

A

skeletal and cardiac muscle condition

  1. traumatic venipuncture
  2. muscle pathology - capture myopathy (myoglobin produced by muscle breakdown causes renal disease)
52
Q

What are 4 causes of hyperglycemia in reptiles? 4 causes of hypoglycemia?

A

HYPER = stress, elevated temperature, pancreatic neoplasia, DM

HYPO = anorexia, malnutrition, severe hepatic disease, septicemia

53
Q

Why is it considerable difficult interpreting reptile radiographs?

A
  • poor tissue contrast in coelom due to minimal visceral fat to provide contrast
  • close anatomic proximity of internal organs
  • no separation of body cavities
  • image degradation due to skin, scales, and osteoderms
54
Q

What are 2 purposes of providing orthogonal views of reptile radiographs?

A
  1. remove summation
  2. spacial location information
55
Q

What kind of radiograph technique is preferred for reptiles?

A

horizontal beams

  • lateral vertical beams alter confirmation of coelomic structures
  • less manipulation of animal
56
Q

Beam comparison:

A
  • lateral, vertical beam - pulmonary tissue obscured by coelom
  • lateral, horizontal beam - better view of pulmonary tissue
  • lateral, horizontal beam with better restraining
57
Q

How do respiratory interpretation of radiographs compare in reptiles?

A

mammal lung patterns are not applicable

  • many reptile species themselves have anatomic variations
58
Q

What are the best views for lizard radiographs? How are they positioned?

A

lateral and DV

pull legs out to minimize superimposition (may require sedation)

59
Q

What are 3 unique structures of lizards to keep in mind when interpreting radiographs?

A
  1. coelom lacks diaphragm
  2. contain coelomic fat pads
  3. may or may not have a urinary bladder
60
Q

Where is the heart located in lizard radiographs? What should be assessed for?

A

cranioventral coelom —> obscured by thoracic limbs, poor visualization on DV

  • cardiomegaly
  • tracheal position
61
Q

What is being pointed to in these radiographs of a lizard?

A

heart

62
Q

What is going on in this radiograph of a lizard?

A

soft tissue opacity cranial to a large heart, which is displacing the trachea dorsally

63
Q

How do the lungs of lizards compare to mammals? What should be assessed for?

A

more radiolucent

  • abscess/granuloma
  • neoplasia
  • pneumonia
64
Q

What is the best view for interpreting the GIT of lizards? How does it typically move? What is the direction of how it runs?

A

DV —> anatomy depends on species

moves dynamically with the respiratory system

pylorus —> duodenum runs caudal —> cranial

65
Q

What commonly causes prolonged GIT time?

A

decreased temperatures

66
Q

What is labeled in this radiograph?

A
  • red = heart
  • green = liver
  • purple = purple
  • blue = gonad
  • yellow = kidney
  • orange = fat pad
67
Q

What is outlined in this radiograph of a lizard?

A

female reproductive tract

68
Q

How do pre-ovulatory ova look on radiographs?

A

spherical with a soft tissue opacity

(hemoclips seen in this radiograph, too)

69
Q

How do post-ovulatory ova look on radiographs?

A

ovoid +/- visibly shelled

70
Q

Where are the kidneys of lizards found? What should they be assessed for on radiographs?

A

dorsocaudal coelom

  • renomegaly
  • mineralization
71
Q

What pathology is commonly associated with lizard urinary bladders (if they contain them)?

A

uroliths —> radiopaque; lamellar/concentric, irregular, rounded shape

  • commonly found in bladder, colon, or cloaca
72
Q

What is the reference for mineralization in lizards? What 5 things should be assessed for?

A

limbs compared to spine

  1. NSHP - decreased mineral density, fibrous proliferation, thinned cortices, long bone bowing, pathologic fx, periosteal reactions
  2. trauma - fx, joint subluxation, fibrous/mineralized callus can be seen within 8 weeks to 6 months; clinical healing precedes radiographic healing
  3. infection - lytic osteomyelitis, osteopathy
  4. gout - articular lysis
  5. soft tissue mineralization
73
Q

Interpret findings in these radiographs.

A
  • post-ovulatory ova seen
  • poor bone density of distal limbs compared to spine

likely laying calcium into eggs, causing mobilization of calcium from bone —> negative energy balance = metabolic bone disease

74
Q

Interpret findings in this radiograph.

A
  • decreased mineral opacity of limbs
  • kyphosis mid-spine to tail
75
Q

Interpret findings in these radiographs.

A
  • spinal kyphosis
  • tail scoliosis
  • periosteal reactions on long bones
76
Q

What is osteitis deformans?

A

spinal osteopathy resulting in osteomyelitis and bone proliferation

77
Q

What is the best view for radiographs in snakes? How should they be positioned?

A

lateral —> DV has superimposition of spine and ribs

sequential down the body (can straighten with a snake tube)

78
Q

What is the snake heart like? What causes a normal increase in its density? What should be assessed for?

A

highly mobile and present at 20-35% snout to vent length (cranial in arboreal species; caudal in aquatic species)

post-prandial cardiac hypertrophy in boids

  • cardiomegaly
  • tracheal position
  • displacement of ventral body wall
79
Q

How many lungs to most snakes have? Where is it located?

A

most have 1 right lung and 1 vestigial left lung —> boids have both present

homogenous gas opacity typically starting at the cardiac silhouette at 25-60% SVT

80
Q

How is the snake GIT visualized in radiographs? Where are the stomach, intestines, liver, and cloaca found?

A

poorly visualized and significantly affected by previous feeding

  • STOMACH = 45-65% SVL (superimposed by liver)
  • INTESTINES = 65-100% SVL
  • LIVER = 30-60% SVL
  • CLOACA = at last pair of ribs
81
Q

Where are the gonads found in snakes? How do they compare in oviparous and viviparous species?

A

60-80% SVL

  • OVIPAROUS = round to ovoid soft tissue structures, mineralized shells, retained eggs are more radiopaque
  • VIVIPAROUS = fetal skeletons in late gestation
82
Q

Where are the kidneys found in snakes? What should be assessed for?

A

70-95% SVL dorsal to the intestinal tract near the fat bodies

  • gout
  • renomegaly = displaced GIT and constipation
  • masses
83
Q

What is seen in this radiograph?

A
  • mineralization of kidneys
  • cloaca at last pair of ribs
84
Q

What reference is used for proper musculoskeletal mineralization in snakes? What should be assessed for?

A

ribs compared to spine

  • NSHP (rare, carnivores)
  • fractures
  • spondylitis, spondylosis
  • spinal osteopathy
  • osteomyelitis
  • neoplasia
85
Q

What are the best views used for radiographs of chelonians?

A
  • ideally horizontal beam, REQUIRE 3 views
  • CV, craniocaudal, lateral
86
Q

What do lateral views of chelonian radiographs give the best view of?

A

dorsal lung field vs coelomic cavity

  • cervical vertebrae going into lung field due to retraction of head into shell
87
Q

What do craniocaudal views of chelonian radiographs give the best view of?

A

lung fields

  • superimposition of pectoral girdle seen
88
Q

What do DV views of chelonian radiographs give the best view of?

A

GIT

89
Q

What musculoskeletal reference is used for mineralization in chelonians?

A

pectoral girdle

90
Q

What is recommended for interpreting the cardiovascular system of chelonians?

A

echo or CT with contrast

  • radiograph hard to read based on superimposition of pectoral girdle
91
Q

How does the normal lung field of chelonians look like on radiographs? What can affect filling? What should be assessed for?

A

edicular (spongy) with muscular bands (ST opacity) and pulmonary vasculature; dorsally adheres to carapace

position of head and thoracic girdle

  • abscess/granuloma
  • neoplasia
  • pneumonia (honeycomb ST opacity)
92
Q

Chelonian, pneumonia:

A
  • honeycomb pattern
  • GI FB = gravel —> likely causing pulmonary pathology due to aspiration
93
Q

What is the best view for interpreting the GIT of chelonians? Where is the stomach seen? What is commonly seen within it?

A

DV

left mid coelom

gravel —> can be normal, but may cause constipation, altered size of intestines, or gas opacities

94
Q

What is commonly seen in female chelonian reproductive tracts?

A

visibly mineralized shelled eggs

95
Q

What are 4 signs of dystocia in radiographs of chelonians?

A
  1. enlarged egg
  2. fractures shell
  3. eggs seen outside of season
  4. thicker shells = more opaque

can be retained in reproductive tract, urinary bladder, cloaca, or coelom (salpinx/oviduct rupture)

96
Q

What are the 2 major aspects of the urinary system able to be seen in radiographs of chelonians? What pathology is commonly associated?

A
  1. KIDNEYS - dorsocaudal coelom
  2. URINARY BLADDER - species variation on # of lobes (increased in desert species for water retention)

UROLITHS - radiopaque, lamellar/concentric, commonly found in bladder or cloaca

97
Q

How should the musculoskeletal system of chelonians be assessed?

A
  • NSHP (metabolic bone disease)
  • trauma - fracture, joint subluxation, callus (seen in shell within 12-18 months), persistent lucent defect possible
  • osteomyelitis
  • septic arthritis
  • DJD

Exotics & Lab Animal Medicine (20 decks)

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